Hi - I was just wondering if there wasn't a possibility that one could transition yo hydro cortisone. I understand it's 'safer' (less side effects) cortisone - but is it still as effective.
I am trying to taper my Pred from 11 to 10 at present - but struggling. No full blown pain but reall heaviness in arms and legs. Is it time for me to start the DSNS method?
Thanks!!
Doesn't Hydrocortisone just do allergies? Non Steroidal Anti Inflammatory Drugs don't work on PMR either. What's DSNS?
I'm not sure. My brain is pretty fuzzled!
DSNS stands for 'Dead Dlow Nearly Stop' it is a method of tapering down.
The recommendation to switch to hydrocortisone is not for the benefit of the PMR per se but it is hoped that the return of good adrenal function will be encouraged by doing so.
It isn't really "safer" nor does it really have fewer side effects - it is a corticosteroid just the same and everyone is different. I have no pred side effects for example. The downside in using it for PMR would be that you probably need dosing at least twice and possibly 3 times daily - because the duration of the antiinflammatory effect is much shorter. In pred it varies from 12 to 36 hours whereas with HC it may be as little as just a few hours. It is also dosed 2 or 3 times daily for adrenal insufficiency - better mimicking the way cortisol is produced naturally.
You may be approaching the dose you are looking for: the lowest dose that manages the inflammation and your symptoms as well as the starting dose did. DSNS can be used right from the start - there is no reason why not. It doesn't mean though that you won't get lower - just not yet. The activity of the underlying autoimmune disorder probably varies - cycling so it is more active at times than others. Sometimes it helps to rest at a dose for a month or so and then try the next step down.
As usual - thank you so much for your clear explanation PMRPro
DSNS
Endocrinologist and Hydrocortisone
Hydrocortisone and pain.
